Hair-loss in men is something that we are now comfortable talking about. But hair-loss in women is, regrettably, a more taboo subject. However, it won’t stay that way, as increasing numbers of women seek a solution to their all-too-common problem.
And as techniques for addressing hair-loss become more sophisticated and more design-led, there is now a growing understanding that hair-loss [and its associated difficulties for women] is a problem we can do something about.
Alongside this, Paradigm clinic is aware that female hair-loss often carries with it a very significant undermining of self-esteem - and we take this into account when working with our patients.
Crucially, a female hair line is not the same as a male hair line. And because of this, it is very important that transplants for female patients are designed to take into account the greater complexity and variation in their hair lines. Quite literally, this is not a straight-forward matter as female hair lines display a pattern of variation that male hairlines simply do not.
Moreover, many of the non-surgical treatments for men have differing outcomes and side effects in women and are therefore not-suitable to be prescribed or used in the same way.
It may be unfashionable to say that men and women are very different, but when it comes to hair-loss treatment and management, it is indisputably the case. Therefore clinicians need particular experience of working with female patients and transplanting the complicated female hair lines so that appearance can be enhanced in a skillful, experienced and knowledgeable way.
Our personal experience of this common condition is reflected in the scientific studies which show that female pattern hair-loss can occur in up to 20 to 30%of the female population1.
While hair-loss occurs in up to 50% of the male population, hair-loss is a variant and accepted norm for many men. On the other hand, hair-loss for females is not considered ‘normal’ and hence the devastating psychological effects when it does occur.
The most common hair-loss type is often seen as a facet of the aging process and is more properly termed Female Pattern Hair Loss (FPHL).
Female pattern hair-loss (formerly female androgenetic alopecia), is primarily a genetic condition arising from many different genes - hence its unpredictable nature.
Many cases often arise as the first-affected member of a family, that is to say, with no clear prior family history.
Some studies have identified a number of possible risk factors for patterned hair-loss including;
- increased weight
- lower number of births
- polycystic ovarian disease (PCOD)
Female pattern hair-loss does, however, present in a different fashion compared to male pattern hair-loss. While male pattern hair-loss demonstrates characteristic recession and complete loss of hair in the temples and/or crown, in female pattern hair-loss there is a definite preservation of the hairline position, but there is nevertheless a diffuse thinning process within and behind the hairline.
Like male pattern hair-loss, there is also preservation of hair density in the occipital region, that is, on the back of the scalp. This preservation of hair at the back is exploited in the hair transplantation process by ‘moving’ hair from the scalp at the back to the front.
This female pattern of hair-loss has been characterized in the classifications [seen below] and, as one can see, there can be the gradual reduction in follicle density which can ultimately lead to complete loss of hair. Although this is very rare.
- Ramos PM 1, Miot HA 1. Female Pattern Hair Loss: a clinical and pathophysiological review. An Bras Dermatol. 2015 Jul-Aug;90(4):529-43.
- Lucky AW1 et al. A randomized, placebo-controlled trial of 5% and 2% topical minoxidil solutions in the treatment of female pattern hair loss. J Am Acad Dermatol. 2004 Apr;50(4):541-53.
- van Zuuren EJ1, Fedorowicz Z, Schoones J. Interventions for female pattern hair loss. Cochrane Database Syst Rev. 2016 May 26;(5).
- Khandpur S1 et al. Comparative efficacy of various treatment regimens for androgenetic alopecia in men. J Dermatol. 2002 Aug;29(8):489-98.
- Piérard-Franchimont C1et al. Ketoconazole shampoo: effect of long-term use in androgenic alopecia. Dermatology. 1998;196(4):474-7.
- Kim H1et al. Low-level light therapy for androgenetic alopecia: a 24-week, randomized, double-blind, sham device-controlled multicenter trial. Dermatol Surg. 2013 Aug;39(8):1177-83.
- Puig CJ1et al. Double-Blind, Placebo-Controlled Pilot Study on the Use of Platelet-Rich Plasma in Women With Female Androgenetic Alopecia. Dermatol Surg. 2016 Nov;42(11):1243-1247.